Bolstered by strong support in Africa, Europe and Latin America, there are high hopes that an ambitious new Global Action Plan on Climate Change and Health will be approved in May by the World Health Assembly, said WHO’s Maria Neira, Director of the Department of Climate, Environment and Health. 

The WHO moves will also help set the stage for an initiative by Brazil on a “Bélem Action Plan” on climate change and health at COP30, in Bélem, Brazil – which aims to reinforce UN Member states’ commitments to include health goals in their climate strategies, said Gustavo dos Santos Souza, coordinator of Climate Change and Health Equity in Brazil’s Ministry of Health.

“We are advancing several COP-specific initiatives,” Souza said. “Our focus is to present an action plan on climate change and health, which we are considering naming the Bélem Action Plan.

“The goal of this plan is to support countries implementing equitable health adaptation strategies and policies in response to climate change. This plan will align its goals and objectives with the global goal on adaptation under the UNFCCC, reinforcing the need for a unified global approach with a minimal set of measurable outcomes, it will also apply specific adaptation strategies to strengthen health system resilience to climate-related impacts. And we hope countries will voluntarily endorse this plan in Brazil.”

Neira and Souza were speaking, along with representatives from The Netherlands and civil society, at a panel Thursday on Health at the Heart of Climate Action, hosted by the Global Health Centre of the Geneva Graduate Institute. 

Ambitious new Global Plan of Action upcoming at the World Health Assembly

The discussion also focused on the upcoming WHO Global Plan of Action, that is to go before member states at the May World Health Assembly, which was subject to an initial review at February’s meeting of the WHO Executive Board, the 34-member governing body. 

The new action plan, anchored in a WHA resolution on Climate and Health approved in 2024, takes a bolder and more holistic approach to the issue, as compared to previous WHO climate initiatives. Past initiatives, anchored in a 2008 WHA resolution,  had focused mainly on  “adaptive” actions such as promoting health sector resilience to climate change through measures such as improved early warning systems for climate sensitive disease outbreaks. 

In contrast, the new action plan asks member states to take a stronger lead in climate mitigation efforts that also generate significant health co-benefits.  

These include:  “stronger engagement in the circular economy and through the reduction of greenhouse gas emissions and other climate-changing pollutants, such as black carbon, through more sustainable energy-use choices, agricultural practices, transport options, reduced food loss and waste, city densification and use of industrial technology and practices, as well as through support for healthier diets in low-income populations, with special attention to women of reproductive age, while promoting a shift to healthier and more environmentally sustainable diets among higher-income groups.”

The draft also encourages member states to “limit or reduce actions that cause emissions in other countries through manufacturing, shipping or energy production,” as well as to “promote demand-side mitigation that encompasses changes in infrastructure use, end-use technology adoption, and sociocultural and behavioural changes.”

Developing countries seek more emphasis on adaptation, and climate equity

During the EB debate, African countries asked for more WHO focus on climate finance to support adaptation and resilience strategies critical to the continent. China, backed by other developing country partners, asked for more emphasis on “common but differentiated responsibilities” a reference to the historical role of industrialized economies in creating most of the climate problem. 

At the same time, Neira expressed confidence that the plan of action would be approved by the WHA in May – even at a time when the United States and other conservative member states are rolling back commitments on climate action. At the EB debate, Russia, a major oil and gas producer, was the only country to vocally oppose the initiative, while the US, which has announced it is withdrawing from the WHO, was silent.

Said Neira, “This is about health, and therefore is our business as the health community, and it’s the business of the member states in the World Health Assembly.”  

“The little issues we have, honestly, I don’t think there are real challenges. Some countries will see more balance on adaptation versus mitigation. Other countries will like [more] reference to common but differentiated responsibility.  Other countries,  maybe due to a conflict of interest, are not very keen on us talking too much about fossil fuels.  So let’s talk about renewable energy, this will benefit our health. Is that okay?”

Convergence on climate resilience for health sector  

One place that has seen a strong convergence of diverse points of view is around bolstering the climate resilience of the health sector – a major element in the WHO global plan of action, as well as of Brazil’s thrust in the lead-up for COP.   

That agenda also has a great deal of elasticity, Neira pointed out – motivating developed countries to devise strategies to “decarbonize” health facilities with energy efficiency solutions.

And at the same time, for low- and middle-income countries, the agenda can address basic shortages in clean water and sanitation, as well as better electricity access – through renewable energy solutions, she pointed out.  

“It’s about how the health system can contribute, but by decarbonizing and reducing our own carbon footprint,” Neira said. It is a footprint that can exceed 5% of a country’s GHG emissions in affluent economies – and as much as 7% in The Netherlands, rivalling that of the aviation industry. 

In contrast, an estimated 12-15% of the health facilities in South Asia and Sub Saharan Africa respectively lack access to any electricity, and some 50% of health facilities in Sub Saharan Africa lack a reliable electricity supply, according to a recent WHO assessment. 

“And a little detail: if you want to do telemedicine, you need to have electricity, and that’s why we want to solarize the healthcare facilities, because otherwise they don’t have access to electricity,” she added. 

Win-wins

Across developed and developing country settings, there are common win-wins to be had, not only from clean energy but from other climate-friendly solutions, Neira pointed out. 

Shifting over to biodegradable plastics, for instance, is a potential solution that is good for well-funded and poorly funded clinics alike.  Plastics made from fossil fuels produce toxic air pollutants such as dioxins and furans, when burned or buried. In contrast, biodegradable plastic waste could also be used as an input to biogas, a clean source of energy. 

“So you have the director of a hospital in a very rural area”and the director of a big hospital in Milan, and somebody working in the private sector, all saying, ‘okay, we can reduce plastic, we can innovate on new materials that will replace plastic.’  

A new WHO-managed initiative, ATACH, (the Alliance for Transformative Action on Climate and Health), is already busy promoting such solutions  – with 90 member states active on the platform – exchanging knowledge about climate resilient, low carbon health facility strategies and technologies, Neira noted.  

 “You can’t imagine the motivation that this is generating” Neira said, noting that the measures are also highly cost-efficient, as well as being “about how the health system can contribute, but by decarbonizing and reducing our own carbon footprint.” 

Grappling with the global wave of populism and climate skepticism 

One future challenge facing WHO and member states is the new, populistic wave of  political conservatism sweeping the world, with the victory of Donald Trump in recent United States elections as a watershed moment, globally. 

At the same time, most governments, even more conservative ones, continue to acknowledge that climate change is an important challenge, said Astrid Dunselman, of the Ministry of Health, Welfare and Sport in the Netherlands – which co-led negotiations on the 2024 WHA resolution on Climate and Health.  

“We also have a more conservative or right wing government after our elections compared to the one that started off the work on the WHA resolution [negotiations] that we co chaired,” said Dunselman.  “And yet still, also for our current government, climate change and health is still a priority,” she said. 

“And the reason is health is where climate change gets personal. So we all will experience the effects of climate change on our well being and on that of our families, and I think that it is politically, speaking, still an issue.” 

‘Primary prevention’ is climate change mitigation 

In The Netherlands, climate is also a topic formally included in the portfolio of the State Secretary for Health, Welfare and Sport, she added, noting that this signals a recognition “of the importance of taking measures to truly prevent health issues before they even arise.” 

Some examples, added Neira, include the seven million deaths annually from air-pollution-related diseases – with a significant proportion of that pollution created by fossil fuel emissions from electricity production, transport, building heating and cooling systems, and industry – as well as the unsustainable use of wood and charcoal as fuels in poor homes. 

Other, more indirect examples, include the estimated 5 million deaths from diseases related to unhealthy diets produced by carbon-intensive farm systems, and physical inactivity in cities overwhelmed by traffic and smog. 

“Mitigating climate change means nothing else done to do pure public health interventions,” she asserted.  

“When we talk about mitigation of climate change, we are talking about transition to clean sources of energy. This is a huge public health agenda. What a coincidence that air pollution causes and climate change causes overlap at 75%, including fossil fuels. So an energy transition means that we can have less exposure to pollution, and more efficient energy in our buildings and cities.” 

Addressing climate skeptics

And the link between protecting the climate and protecting health, Neira added, should also be foremost in discussions with climate skeptics – including the new United States administration. 

Already in January, new US President Donald Trump declared that he was leading the country out of the WHO over its handling of the COVID pandemic. 

Since then, Washington has launched a major effort to stamp out climate-related language and initiatives from the US Forest Service, Department of Agriculture, Environmental Protection Agency, and more. And there are strong signals that it will pursue the same agenda in its foreign policy agenda. 

In a statement to the World Food Programe’s annual meeting in Rome this week, the US Mission told WFP to immediately halt work on “gender ideology and wasteful diversity, equity, and inclusion (DEI) programmes,” but added that climate was also on its radar. 

“It is right and proper for WFP to assist people who have been hard hit by weather events,” the statement said, but warned that, “ The United States may advance other needed areas of correction or recalibration – such as regarding climate change initiatives – in the UN system’s work.”

‘We have a big catalogue of arguments to dialogue around’ 

As for WHO, “definitely we want the US back to WHO.  We don’t want them to go. It’s an extremely important member state among the 194 that we have,” Neira told the GHC fora. 

“But at the Executive Board meeting discussions around climate change, we had many countries in Africa saying ‘you don’t need to explain to me what climate change is and how it’s affecting health. I see it every day.’ The same in Asia. 

“And when you look at the WHO Global Health Observatory [database], you will see that the number one risk factor for health, competing very heavily with tobacco, is exposure to air pollution,” she added. 

“From the need to improve the quality of the air we breathe to the rise in dengue cases in South East Asia, this is all about public health interventions.  And when you look at issues related to vulnerability and displacement, I think we have a big catalogue of arguments to dialogue around – why we identify climate change as one of the biggest health risks that we face. And this would be my response….We will be very happy to discuss.”

Image Credits: Yoda Adaman/ Unsplash, UNDP/Karin Schermbrucker for Slingshot , Janusz Walczak/ Unsplash.